Nursing 612 API Adult Gerontology at St Thomas University

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Free Nursing 612 API Adult Gerontology at St Thomas University Questions

1.

Sharon is a 70-year-old patient with venous ulcers to her right lower extremity. She has a history of multiple pregnancies and surgeries, and has a sedentary lifestyle. Which of the following may be possible contributing factors to her diagnosis given her history? Select all that apply.

  • Parkinsonism

  • History of breast cancer

  • Obesity

  • Reduced mobility

  • Degenerative disease

Explanation

The Correct Answers are:

C. Obesity and D. Reduced mobility.

Detailed Explanations:

C. Obesity:

Obesity increases venous pressure in the lower extremities, impairing venous return and promoting venous stasis. This leads to valve incompetence, edema, and tissue breakdown—key contributors to venous ulcer formation.

D. Reduced mobility:

A sedentary lifestyle or limited mobility decreases the calf muscle pump function, which normally assists in venous return to the heart. Stagnant blood flow in the lower extremities causes chronic venous insufficiency and ulcer development.


2.

Patient education is very important for individuals who have AAA. The patient and their family should be taught the importance of follow-up and the management of which of the following? Select all that apply.

  • Chondromalacia

  • Pain

  • Smoking

  • Hypertension

  • Hypercholesterolemia

Explanation

The Correct Answers are:

B. Pain, C. Smoking, D. Hypertension, and E. Hypercholesterolemia.

Detailed Explanations:

B. Pain:

Pain may indicate aneurysm expansion or impending rupture. Patients should be taught to report new, persistent, or severe abdominal or back pain immediately, as this may signify a medical emergency.

C. Smoking:

Smoking accelerates atherosclerosis, damages vascular walls, and increases aneurysm growth and rupture risk. Complete smoking cessation is crucial to slow aneurysm progression and improve vascular health.

D. Hypertension:

Uncontrolled blood pressure raises wall tension in the aorta, significantly increasing the risk of aneurysm rupture. Strict blood pressure control through medication and lifestyle modification is essential for safety.

E. Hypercholesterolemia:

Elevated cholesterol contributes to atherosclerosis, the underlying cause of most abdominal aortic aneurysms. Managing cholesterol through diet, exercise, and medication helps reduce vascular inflammation and aneurysm progression.


3.

In treating AAA, arterial monitoring is recommended. Which of the following IV antihypertensive agents should be used to rapidly and consistently maintain blood pressure in the mean arterial pressure ranges? Select all that apply.

  • Esmolol

  • Carbidopa

  • Nitroglycerin

  • Nicardipine

  • Sertraline

Explanation

The Correct Answers are:

A. Esmolol and D. Nicardipine.

Detailed Explanations:

A. Esmolol:

Esmolol is a short-acting beta-blocker that provides rapid and precise blood pressure control. It is particularly useful in patients with aortic aneurysm because it reduces heart rate and myocardial contractility, lowering shear stress on the aortic wall and minimizing the risk of rupture.

D. Nicardipine:

Nicardipine is a calcium channel blocker administered intravenously for smooth, titratable control of hypertension. It effectively lowers blood pressure without compromising organ perfusion, making it ideal for managing blood pressure in acute aortic conditions such as an abdominal aortic aneurysm (AAA).


4.

Mrs. Prentiss is diagnosed with symptomatic AAA. The initial treatment is aggressive blood pressure control. At which of the following readings should mean arterial pressure be maintained?

  • Between 80 and 100 mm Hg.

  • Between 60 and 70 mm Hg.

  • Between 90 and 120 mm Hg.

  • Between 100 and 120 mm Hg.

Explanation

The Correct Answer is:

A. Between 80 and 100 mm Hg.

Detailed Explanation:

For patients with symptomatic abdominal aortic aneurysm (AAA), careful blood pressure control is critical to reduce aortic wall stress and prevent rupture. The mean arterial pressure (MAP) should be maintained between 80 and 100 mm Hg to ensure adequate organ perfusion while minimizing pressure on the aneurysm wall. Lower pressures (60–70 mm Hg) risk inadequate perfusion to vital organs, while higher levels (above 100 mm Hg) increase the chance of aneurysm expansion or rupture. Continuous arterial monitoring and IV antihypertensives, such as nicardipine or esmolol, are typically used to maintain this range safely.


5.

The nurse practitioner is preparing discharge instructions for a 79-year-old man with newly diagnosed asthma. Which of the following are important instructions to include? Select all that apply.

  • There is no need to follow up with your doctor unless your symptoms get worse.

  • As you get older, you are more likely to experience difficulty breathing.

  • Symptoms of asthma may include a runny nose or postnasal drip

  • Experiencing strong emotions like anger can trigger an asthma episode.

  • Infections can lead to an occurrence of asthma.

Explanation

The Correct Answers are:

B. As you get older, you are more likely to experience difficulty breathing, C. Symptoms of asthma may include a runny nose or postnasal drip, D. Experiencing strong emotions like anger can trigger an asthma episode, and E. Infections can lead to an occurrence of asthma.

B. As you get older, you are more likely to experience difficulty breathing:

Older adults experience age-related changes in lung elasticity and chest wall compliance, which can worsen asthma symptoms and reduce lung function. This makes proper asthma control and regular monitoring essential to prevent complications.

C. Symptoms of asthma may include a runny nose or postnasal drip:

Upper airway symptoms, such as nasal congestion or postnasal drip, are often associated with asthma and may act as triggers. Managing these symptoms through allergy control and nasal treatments can help prevent asthma flare-ups.

D. Experiencing strong emotions like anger can trigger an asthma episode:

Emotional stress and strong feelings, such as anger, anxiety, or fear, can cause rapid breathing and airway tightening, leading to bronchospasm. Patients should learn relaxation techniques and stress management strategies to reduce this trigger.

E. Infections can lead to an occurrence of asthma:

Respiratory infections, especially viral ones like the common cold or flu, are major triggers for asthma exacerbations. Patients should be advised to practice good hygiene, stay current with vaccinations, and seek early treatment for respiratory illnesses.


6.

PVD is a disease that alters blood flow to or from the extremities and vital organs other than the heart. According to studies, which of the following remains the most important risk factor for PVD?

  • Smoking

  • Family history

  • Hypercoagulopathy

  • Hypertension

Explanation

The Correct Answer is:

A. Smoking.

Detailed Explanation:

Smoking is the most significant and modifiable risk factor for peripheral vascular disease (PVD). Nicotine and other chemicals in tobacco cause vasoconstriction, damage to the endothelium, and promote atherosclerosis, all of which impair blood flow to the extremities. Smoking also decreases oxygen delivery to tissues, accelerates plaque formation, and increases the risk of thrombus development. While family history, hypertension, and hypercoagulopathy contribute to PVD risk, smoking has the strongest direct and dose-dependent association with the disease’s onset and progression.


7.

The nurse practitioner and a student are examining the apical pulse of an 82-year-old man. The student perceives that there is an S4 sound. The nurse practitioner interprets that this is likely:

  • Mitral regurgitation.

  • Normal, due to the man's age.

  • Heart blockage

  • An early ventricular filling.

Explanation

The Correct Answer is:

B. Normal, due to the man's age.

Detailed Explanation:

An S4 heart sound (also called an atrial gallop) occurs just before S1 and results from the atria contracting forcefully to overcome decreased ventricular compliance. This is common in older adults due to age-related stiffening of the ventricular wall or mild diastolic dysfunction. In an elderly person without other signs of heart failure, an S4 is often considered a normal age-related finding.


8.

Which of the following conditions is signaled by symptoms of swelling of the affected body part, usually the limb, because of impaired flow of lymph fluid?

  • Abdominal aortic aneurysm (AAA)

  • Peripheral vascular disease (PVD)

  • Lymphedema

  • Venous ulcers

Explanation

The Correct Answer is:

C. Lymphedema.

Detailed Explanation:

Lymphedema is a chronic condition characterized by swelling—most often in the arms or legs—due to impaired lymphatic drainage. It occurs when lymph fluid cannot properly circulate and accumulates in the tissues. The swelling is typically firm, non-pitting, and may progress over time, causing discomfort, skin thickening, and reduced mobility.


9.

The nurse practitioner implements an approved plan of care proposed in the National Asthma Education and Prevention Program Expert Panel Report-3 (NAEPP-EPR-3) for an older adult patient with asthma. This includes which of the following? Select all that apply.

  • Monitoring of appropriate use of medications.

  • Patient, family, and professional education so as to create a partnership in asthma management.

  • Control of comorbidities.

  • Use of a standardized asthma care plan

  • Completion of the assessment and monitoring, as this is not an ongoing process.

Explanation

The Correct Answers are:

A. Monitoring of appropriate use of medications, B. Patient, family, and professional education so as to create a partnership in asthma management, C. Control of comorbidities, and D. Use of a standardized asthma care plan.

Detailed Explanations:

A. Monitoring of appropriate use of medications:

Regular monitoring ensures proper use of both controller and rescue medications, promoting adherence and preventing overuse or underuse that could worsen symptoms or cause side effects.

B. Patient, family, and professional education so as to create a partnership in asthma management:

The NAEPP emphasizes a collaborative approach involving patients, families, and healthcare providers. Education enhances understanding of triggers, medications, and self-management techniques.

C. Control of comorbidities:

Managing related conditions such as allergic rhinitis, GERD, and obesity improves asthma control and reduces exacerbations.

D. Use of a standardized asthma care plan:

A written, evidence-based asthma action plan guides daily management and provides instructions for handling worsening symptoms or attacks.


10.

Treatment to slow the progression of PAD should include which of the following? Select all that apply.

  • Conservative

  • Surgical

  • Pharmacological

  • Heat

  • Immobilization

Explanation

The Correct Answers are:

A. Conservative, B. Surgical, and C. Pharmacological.

Detailed Explanations:

A. Conservative:

Conservative management is the first-line approach for peripheral arterial disease (PAD). It includes lifestyle modifications such as smoking cessation, regular exercise (especially walking programs), weight control, and a heart-healthy diet. These interventions improve circulation and slow disease progression.

B. Surgical:

Surgical or interventional procedures, such as angioplasty, stent placement, or bypass grafting, are used in severe cases to restore adequate blood flow when conservative and medical therapies are insufficient.

C. Pharmacological:

Medications such as antiplatelet agents (aspirin or clopidogrel), statins, and cilostazol help improve blood flow, prevent clot formation, and reduce atherosclerotic progression.


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